Posture

Posture is essentially the position of the body in space, the relationship of the body parts—head, trunk, and limbs—to each other. Changes in posture occur when any part of the body is moved (5).

Optimal or ideal posture is the state of muscular and skeletal balance that protects the supporting structures of the body against injury or progressive deformity, whether at work or rest. It involves the positioning of the joints to provide minimum stress on the body.

Faulty posture increases stress on the joints. Increased stress can be compensated for by strong muscles, but if they are weak or the joints lack mobility or are too mobile, joint wear and modification can occur (1,5). Damage and changes to the surrounding tissues can also occur.

Posture involves the chain-link concept of body mechanics in which problems anywhere along the body chain can lead to problems above or below that point. Examples (5):
  • Low back or knee pain can arise from pelvic joint disorders.
  • Headaches, eyestrain, and neck and upper back pain can be caused by the head being too far forward or rearward.

Causes of poor posture

The causes of faulty posture can be divided into two categories: positional and structural.

Structural causes are basically permanent anatomical deformities that may not amenable to correction by conservative treatments. However, some leg length inequalities and some ankle and foot issues can be corrected conservatively.

Positional causes of poor posture include (5):
  • poor postural habit—for whatever reason, the individual does not maintain a correct posture
  • psychological factors, especially self-esteem
  • normal developmental and degenerative processes
  • pain leading to muscle guarding and avoidance postures
  • muscle imbalance, spasm, or contracture
  • joint hypermobility or hypomobility
  • respiratory conditions
  • general weakness
  • excess weight
  • loss of proprioception—the ability to perceive the position of your body
  • over reliance on passive support from a non-ergonomic chair
 

Correcting postural faults

Postural faults must be accurately analysed before they can be effectively corrected (5,11).

Examination should include the following (5):

  • observation of the patient as they sit and move about
  • spinal alignment
  • if appropriate: measurement or estimation of the deviation from ideally erect postures using plumb lines, inclinometry, and posture guides —done in three or all four views
  • limb length and girth measurements
  • flexibility tests and joint mobility tests
  • muscle length and strength tests


Conventional corrective therapies

The Chiropractors and Osteoapths at Tweed Coast Chiropractic use a number of techniques to try and improve poor postural and body mechanics. Manipulation to release accompanying fixations, soft tissue therapies, dynamic neuromuscular stabilisation, stretching; strengthening exercises (rehabilitation) (9,10,11,12); and if necessary supportive measures to treat ligaments, bones, and nerves (eg orthotics, heel lifts) or referral to other appropriate practitioners.

Addressing posture (eg in the workplace and on the home computer) can be important in maintaining a healthy structure (2,3,4,6,7,8).

Source: Vic Weatherall - correcting faulty posture - www.advancechiro.on.ca/correcting-faulty-posture/




References:

1. Adams MA, Hutton WC. Gradual disc prolapse. Spine 1985;10:524-531.

2. http://www.healthdirect.gov.au/workplace-health

3. Australian Government Comcare. Officewise: a guide to health and safety in the office (updated July 2008). http://www.comcare.gov.au/forms and publications/publications/safety and prevention/officewisea guide to health and safety in the office ohs 1 (accessed May 2012).

4. WorkCover NSW. Health and safety in the office, 2004. http://www.workcover.nsw.gov.au/formspublications/publications/Documents/health and_safety_in_the_office_guide_1319.pdf (accessed May 201

5.. Magee DJ (2008). Orthopedic Physical Assesment Ed 5. pg 972-1012. Saunders Elsevier. ISBN-13:978-0-7216-0571-5

6. Victor CW Hoe , Donna M Urquhart , Helen L Kelsall and Malcolm R Sim (2012). Ergonomic design and training for preventing work-related musculoskeletal disorders of the upper limb and neck in adults. Online Publication Date: August 2012. Cochrane Database

7. Wennberg P, Boraxbekk CJ, Wheeler M, Howard B, et al (2016). Acute effects of breaking up prolonged sitting on fatigue and cognition: a pilot study. BMJ Open. 2016 Feb

8. Sherrod C, Johnson D, Chester B (2014). Safety, tolerability and effectiveness of an ergonomic intervention with chiropractic care for knowledge workers with upper-extremity musculoskeletal disorders: a prospective case series. Work. 2014;49(4):641-51. doi: 10.3233/WOR-131732.

9.. Kolar P, Kobesova A, Valouchova P, Bitnar P. Dynamic Neuromuscular Stabilization: developmental kinesiology: breathing stereotypes and postural-locomotion function, Recognizing and Treating Breathing Disorders, 2014;11-22, 978-0-7020-4980-4.

10. Kobesova A, Safarova M, Kolar P. Dynamic Neuromuscular Stabilization: Exercise in the developmental positions to achieve spinal stability and functional joint centration, Oxford Textbook of Musculoskeletal Medicine, 2015:678-689, 978-0-10-967410-7.
11. Lewit K, Kobesova A. A soft Tissue Manipulation, Rehabilitation of the Spine. A Practitioners Manual. 2nd ed, Lippincott Williams and Wilkins 2006:388-402, 0-7817-2997-1
12.KobesovaA, Kolar P, Developmental Kinesiology; Three levels of motor control in the assessment and treatment of the motor system, Journal of Bodywork & Movement Therapies (2013).


Useful Links:
http://advancechiro.on.ca/posture_nf.htm.
http://www.chiroweb.com/find/exercise.html